Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion

Michael Kuan Yew Hsin, Ilker Iskender, Daisuke Nakajima, Manyin Chen, Hyunhee Kim, Pedro Reck Dos Santos, Jin Sakamoto, Jingu Lee, Kohei Hashimoto, Constantine Harmantas, David Hwang, Tom Waddell, Mingyao Liu, Shaf Keshavjee, Marcelo Cypel

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background Ex vivo lung perfusion (EVLP) allows normothermic evaluation and treatment of donor lungs not currently acceptable for transplant and improves organ use. Donor lungs undergo a period of cold preservation before (cold ischemic time [CIT]-1) and after (CIT-2) EVLP. We investigated the effect of an extended CIT-2 on lung function after transplantation. Methods Explanted pig lungs, preserved in low-potassium dextran flush (Perfadex) at 4°C for 10 hours, were subjected to 6 hours of EVLP. They were subsequently allocated to 2 groups: short CIT-2 (CIT-2 = 2 hours; n = 5), and long CIT-2 (CIT-2 = 10 hours; n = 5). In a control group (n = 6), explanted lungs were placed in cold static preservation for 24 hours without EVLP. After the total preservation period, the left lung was transplanted in all groups. Results After 4 hours of reperfusion, oxygenation function, acute lung injury score, inflammatory markers, and cell death pathway markers were similar between short and long CIT-2 groups. Both EVLP groups fared significantly better than the control group in oxygenation function (p < 0.05). Conclusions The intervention of EVLP improved lung function after transplantation, and this was not affected by a prolonged cold static preservation time after EVLP. These results provide the basis for a practical prolonged lung preservation strategy using a combination of cold and warm preservation techniques, which may improve lung transplantation logistics and outcomes.

Original languageEnglish
Pages (from-to)130-136
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume35
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1
Externally publishedYes

Fingerprint

Perfusion
Cold Ischemia
Lung
Transplantation
Control Groups
Lung Transplantation
Acute Lung Injury
Dextrans
Reperfusion
Potassium
Cell Death
Swine
Transplants

Keywords

  • ex vivo lung perfusion
  • lung evaluation
  • lung physiology
  • lung preservation
  • lung resuscitation
  • lung transplantation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion. / Hsin, Michael Kuan Yew; Iskender, Ilker; Nakajima, Daisuke; Chen, Manyin; Kim, Hyunhee; Dos Santos, Pedro Reck; Sakamoto, Jin; Lee, Jingu; Hashimoto, Kohei; Harmantas, Constantine; Hwang, David; Waddell, Tom; Liu, Mingyao; Keshavjee, Shaf; Cypel, Marcelo.

In: Journal of Heart and Lung Transplantation, Vol. 35, No. 1, 01.01.2016, p. 130-136.

Research output: Contribution to journalArticle

Hsin, MKY, Iskender, I, Nakajima, D, Chen, M, Kim, H, Dos Santos, PR, Sakamoto, J, Lee, J, Hashimoto, K, Harmantas, C, Hwang, D, Waddell, T, Liu, M, Keshavjee, S & Cypel, M 2016, 'Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion', Journal of Heart and Lung Transplantation, vol. 35, no. 1, pp. 130-136. https://doi.org/10.1016/j.healun.2015.05.017
Hsin, Michael Kuan Yew ; Iskender, Ilker ; Nakajima, Daisuke ; Chen, Manyin ; Kim, Hyunhee ; Dos Santos, Pedro Reck ; Sakamoto, Jin ; Lee, Jingu ; Hashimoto, Kohei ; Harmantas, Constantine ; Hwang, David ; Waddell, Tom ; Liu, Mingyao ; Keshavjee, Shaf ; Cypel, Marcelo. / Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion. In: Journal of Heart and Lung Transplantation. 2016 ; Vol. 35, No. 1. pp. 130-136.
@article{c1db16e56fe24ea9b263b08108cbe141,
title = "Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion",
abstract = "Background Ex vivo lung perfusion (EVLP) allows normothermic evaluation and treatment of donor lungs not currently acceptable for transplant and improves organ use. Donor lungs undergo a period of cold preservation before (cold ischemic time [CIT]-1) and after (CIT-2) EVLP. We investigated the effect of an extended CIT-2 on lung function after transplantation. Methods Explanted pig lungs, preserved in low-potassium dextran flush (Perfadex) at 4°C for 10 hours, were subjected to 6 hours of EVLP. They were subsequently allocated to 2 groups: short CIT-2 (CIT-2 = 2 hours; n = 5), and long CIT-2 (CIT-2 = 10 hours; n = 5). In a control group (n = 6), explanted lungs were placed in cold static preservation for 24 hours without EVLP. After the total preservation period, the left lung was transplanted in all groups. Results After 4 hours of reperfusion, oxygenation function, acute lung injury score, inflammatory markers, and cell death pathway markers were similar between short and long CIT-2 groups. Both EVLP groups fared significantly better than the control group in oxygenation function (p < 0.05). Conclusions The intervention of EVLP improved lung function after transplantation, and this was not affected by a prolonged cold static preservation time after EVLP. These results provide the basis for a practical prolonged lung preservation strategy using a combination of cold and warm preservation techniques, which may improve lung transplantation logistics and outcomes.",
keywords = "ex vivo lung perfusion, lung evaluation, lung physiology, lung preservation, lung resuscitation, lung transplantation",
author = "Hsin, {Michael Kuan Yew} and Ilker Iskender and Daisuke Nakajima and Manyin Chen and Hyunhee Kim and {Dos Santos}, {Pedro Reck} and Jin Sakamoto and Jingu Lee and Kohei Hashimoto and Constantine Harmantas and David Hwang and Tom Waddell and Mingyao Liu and Shaf Keshavjee and Marcelo Cypel",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/j.healun.2015.05.017",
language = "English",
volume = "35",
pages = "130--136",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - Extension of donor lung preservation with hypothermic storage after normothermic ex vivo lung perfusion

AU - Hsin, Michael Kuan Yew

AU - Iskender, Ilker

AU - Nakajima, Daisuke

AU - Chen, Manyin

AU - Kim, Hyunhee

AU - Dos Santos, Pedro Reck

AU - Sakamoto, Jin

AU - Lee, Jingu

AU - Hashimoto, Kohei

AU - Harmantas, Constantine

AU - Hwang, David

AU - Waddell, Tom

AU - Liu, Mingyao

AU - Keshavjee, Shaf

AU - Cypel, Marcelo

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background Ex vivo lung perfusion (EVLP) allows normothermic evaluation and treatment of donor lungs not currently acceptable for transplant and improves organ use. Donor lungs undergo a period of cold preservation before (cold ischemic time [CIT]-1) and after (CIT-2) EVLP. We investigated the effect of an extended CIT-2 on lung function after transplantation. Methods Explanted pig lungs, preserved in low-potassium dextran flush (Perfadex) at 4°C for 10 hours, were subjected to 6 hours of EVLP. They were subsequently allocated to 2 groups: short CIT-2 (CIT-2 = 2 hours; n = 5), and long CIT-2 (CIT-2 = 10 hours; n = 5). In a control group (n = 6), explanted lungs were placed in cold static preservation for 24 hours without EVLP. After the total preservation period, the left lung was transplanted in all groups. Results After 4 hours of reperfusion, oxygenation function, acute lung injury score, inflammatory markers, and cell death pathway markers were similar between short and long CIT-2 groups. Both EVLP groups fared significantly better than the control group in oxygenation function (p < 0.05). Conclusions The intervention of EVLP improved lung function after transplantation, and this was not affected by a prolonged cold static preservation time after EVLP. These results provide the basis for a practical prolonged lung preservation strategy using a combination of cold and warm preservation techniques, which may improve lung transplantation logistics and outcomes.

AB - Background Ex vivo lung perfusion (EVLP) allows normothermic evaluation and treatment of donor lungs not currently acceptable for transplant and improves organ use. Donor lungs undergo a period of cold preservation before (cold ischemic time [CIT]-1) and after (CIT-2) EVLP. We investigated the effect of an extended CIT-2 on lung function after transplantation. Methods Explanted pig lungs, preserved in low-potassium dextran flush (Perfadex) at 4°C for 10 hours, were subjected to 6 hours of EVLP. They were subsequently allocated to 2 groups: short CIT-2 (CIT-2 = 2 hours; n = 5), and long CIT-2 (CIT-2 = 10 hours; n = 5). In a control group (n = 6), explanted lungs were placed in cold static preservation for 24 hours without EVLP. After the total preservation period, the left lung was transplanted in all groups. Results After 4 hours of reperfusion, oxygenation function, acute lung injury score, inflammatory markers, and cell death pathway markers were similar between short and long CIT-2 groups. Both EVLP groups fared significantly better than the control group in oxygenation function (p < 0.05). Conclusions The intervention of EVLP improved lung function after transplantation, and this was not affected by a prolonged cold static preservation time after EVLP. These results provide the basis for a practical prolonged lung preservation strategy using a combination of cold and warm preservation techniques, which may improve lung transplantation logistics and outcomes.

KW - ex vivo lung perfusion

KW - lung evaluation

KW - lung physiology

KW - lung preservation

KW - lung resuscitation

KW - lung transplantation

UR - http://www.scopus.com/inward/record.url?scp=84954075987&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84954075987&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2015.05.017

DO - 10.1016/j.healun.2015.05.017

M3 - Article

VL - 35

SP - 130

EP - 136

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 1

ER -